The present invention pertains to surfical procedures in which a blood vessel or aneurysm must be blocked by pinching off the vessel with a device, either temporarily or permanently, to prevent bleeding or hemorrhaging.
In surgery, and in particular microsurgery techniques, blood vessels, aneurysms and the like, often must be clamped to prevent bleeding and hemorrhaging in very narrow special surroundings. The problem is a particularly burdensome one when clamping deep-lying, craneal aneurysms due to the fact that space and visibility is severely limited by surrounding brain tissue.
Clamps utilized for clamping blood vessels and aneurysms have heretofore generally had a configuration in which the clamp or an end of the clamp is grasped by forceps and squeezed to open the hemostatic end of the clamp for application to a blood vessel. The handling of the clamp by forceps from outside partially conceals the clamp and positions the forceps to substantially obstruct visibility of the clamp and the blood vessel or aneurysm to which the clamp is being applied.
With a clamp configuration in which the clamp is operated by squeezing a portion of the clamp with a pair of forceps, to assure the clamp is not dropped during application, particularly with difficult reaches, the forceps used for applying the clamp generally must have a shaped end portion which captures the clamp. Some designs have even used interlocking means such as a pin which is formed at the tip of the forceps which fits in a corresponding hole formed in the portion of the clamp wherein the clamp is held thereby. This requires the ends of the forceps used for application to be enlarged which further obstructs visibility of the area in which the clamp is being utilized.
Blood vessel and aneurysm clamps have been constructed in two general configurations. In the first the arms of the clamp are pivotally attached to one another at a central location and do not cross over one another so that when the operational end of the clamp is squeezed together the hemostatic end of the clamp opens. The second type of clamp is a one piece construction of spring steel in which the hemostatic ends of the clamp cross over one another so that as the spring expands outwardly the hemostatic ends are closed together. This type of clamp is operated by squeezing the spring portion to open the hemostatic ends. In both of these clamp types the forceps used for application must engage the clamp from outside thereby resulting in the visible obstruction as discussed above.
DE 37 23 167 A1 discloses a clamp for pinching off a blood vessel or aneurysm which is operated by spreading out the operational ends thereof to open hemostatic ends of the clamp for application. It is possible to grasp the clamp with an application instrument from within the operational ends of the clamp, thereby substantially reducing visual obstruction in the area in which the clamp is utilized. Visual effectiveness is improved since the application instrument engages the clamp from within its structure, rather than grasping the clamp from outside, thus reducing the size of the clamp and instrument combination. Furthermore, this construction substantially improve visibility of the hemostatic portion of the clamp at the vessel or aneurysm during application. But this clamp consists of a pair of arms being manufactured of solid material and being assembled by a pin to provide pivotal movement therebetween. The manufacture of this known clamp is costly, especially because of the accuracy of fit being necessary for the pivotal bearing.
There exists a need for a blood vessel or aneurysm clamp being of simple design which can be easily manufactured.